The human spine consists of the bony vertebral bodies with a cartilage portion, which are connected by joints. The intervertebral discs are the “buffer” between the individual vertebral bodies. These are found in the entire spinal column, i.e. from the cervical to the thoracic to the lumbar spine.
Intervertebral discs consist of a fibrous ring (Anulus fibrosus), which surrounds an inner gelatinous core (Nucleus pulposus). The gelatinous core cushions shocks and violent movements so that the vertebral bodies do not rub against each other. This inner gelatinous core can be squeezed out of the fibrous ring for various reasons.
This can happen when the fibrous ring loses its stability and elasticity and develops cracks. The core can then no longer be held in the middle and bulges in the direction of the weak point. This is then called a disc protrusion or disc protrusion. This can occur in all sections of the spine. The difference to a herniated disc (intervertebral disc prolapse) is that in the prolapse the fibrous ring is completely torn and the gelatinous core can emerge, whereas in the protrusion the fibrous ring only has weak points where the core protrudes.
Frequency
In old age, disc protrusions become increasingly frequent. On the one hand, this is due to the aging process of the body and on the other hand to the decreasing mobility and movement. In most people, the first appearance of a disc protrusion occurs between the ages of 30 and 45.
Causes
A disc protrusion can often be traced back to ageing processes in the body, not only in the area of the cervical spine. With age, the intervertebral discs lose fluid and thus elasticity. Due to the constant pressure exerted on the intervertebral discs, they become thinner over time and are no longer able to cushion movements as well as they normally would.
A lack of movement also increases the probability of a disc protrusion or even a herniated disc in the cervical spine. The lack of movement means that the intervertebral discs are no longer sufficiently supplied with nutrients and therefore can no longer perform their function optimally. Since it often leads to a lack of movement, especially in old age, older people are more susceptible to disc disease due to this and the aging process.
But also a too high load on the cervical spine due to too heavy lifting or very fast turning of the head can lead to a disc protrusion. Especially in people who have a weakness of the connective tissue. Often, permanent incorrect strain, such as sitting in front of the computer for hours or driving a car for long periods of time, for example with long-distance drivers, leads to such a clinical picture.
In addition, car accidents involving heavy braking and head spinning forward can lead to disc protrusions in the area of the cervical spine. In the case of a cervical spine disc protrusion, the symptoms are related to the extent of the protrusion, the location and the speed of progression of the disease. If the protrusion of the intervertebral disc develops slowly, the disease often progresses without symptoms for a long time.
Even if the bulging disc does not directly compress a nerve, it is usually not noticed for a long time. However, if the bulging disc presses on one of the spinal nerves that run directly in front of it, this often causes severe pain. If a disc protrudes in the area of the cervical spine, this pain occurs in the neck and upper back.
It is also possible for the pain to radiate into the arms and legs, since the spinal nerves extend to this point. In addition, numbness or tingling sensations may occur in the area of the arms and fingers. Headaches in the back of the head are also a typical symptom.
Dizziness and ringing in the ears can be accompanying symptoms of a disc protrusion. A herniated disc can also lead to paralysis. If the cervical spine is affected, these affect the arms and fingers.
If a disc in the area of the cervical spine has bulged outwards, the cushioning, protective effect of the discs is no longer guaranteed at this point of the spine. This means that parts of the bone of the upper and lower vertebral bodies rub against each other when moving. This can initially lead to slight pain in the neck area, and later to severe pain.
Whether or not symptoms appear in the case of a disc protrusion depends on how quickly the disease progresses and on the location of the protrusion. If the bulge develops over several weeks and months, the patient usually feels no pain. However, if the bulge develops more quickly and compresses (constricts) spinal nerves, this is noticeable as severe pain.
The pain occurs in the neck and upper back, but can also radiate into the arms. This is because the trapped spinal nerves extend from the cervical spine to the fingertips. The pain is often described as very severe and is experienced as dull, deep-seated and sometimes burning.
Certain changes in head position and movements of the shoulders can increase or decrease the pain. Initially, these pains are only present during movement, but later the pain can also occur at rest and be of a very strong character. If the herniated disc is very pronounced, the affected person may also experience numbness in the area of the arms.
Since the neck and head area is connected with many complex nerve connections, pain in the neck area, which is caused by a herniated disc, can also radiate into the head, which leads to unpleasant pain radiating mainly into the back of the head. Tingling in the arms and fingers is also typical for a disc protrusion in the area of the cervical spine. This sensory disturbance is also due to mechanical irritation of nerve fibres and is often described by those affected as “ant walking”.
A numbness in the area of the arms and fingers is also possible if the sensitive nerve fibres are strongly compressed. Another possible symptom of a disc protrusion can be paralysis. In the case of a bulge at the level of the cervical spine, the arms and hands are also affected, so that muscle weakness can occur here.
While pain is a relatively unspecific symptom, a tingling, numbness or paralysis in the arm area is indicative of a bulge or prolapse of the disc in the cervical spine. At the latest when a muscle weakness is observed, a doctor should be consulted, as this muscle weakness can in extreme cases also affect the respiratory muscles. However, weakness of the musculature occurs less frequently when the intervertebral disc protrudes and is more likely to indicate a manifest herniated disc.
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